Healthcare professionals’ perspectives of the provision of, and challenges for, eating, drinking and psychological support post-stroke: findings from semi-structured interviews across India

Abstract

Aim: This qualitative study explores with health professionals the provision of, and challenges for, post-discharge stroke care, focussing on eating, drinking and psychological support across India.
Design: Qualitative semi-structured interviews.
Setting: Seven geographically diverse hospitals taking part in a Global Health Research Programme on Improving Stroke Care in India
Participants: A purposive sample of healthcare professionals with current experience of working with stroke patients.
Results: Interviews with 66 healthcare professionals (23 nurses (14 staff nurses; 7 senior nurse officers; 1 Intensive Care Unit nurse; 1 palliative care nurse)); 16 doctors (10 neurologists; 6 physicians); 10 physiotherapists; 5 speech and language therapists; 4 occupational therapists; 4 dieticians; 2 psychiatrists; and 2 social workers) resulted in three main themes: Integrated inpatient discharge care planning processes; Post-discharge patient and caregiver role and challenges; Patient and caregiver engagement post-discharge.
Conclusions: Discharge planning was integrated and customised, although resources were limited in some sites. Task-shifting compensated for a lack of specialists but was limited by staff education and training. Caregivers faced challenges in accessing and providing post-discharge care. Post-discharge care was mainly hospital-based, supported by tele-services, especially for rural populations. Further research is needed to understand post-discharge care provision and the needs of stroke survivors and their caregivers.